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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12625000118404
Ethics application status
Approved
Date submitted
16/01/2025
Date registered
3/02/2025
Date last updated
29/05/2025
Date data sharing statement initially provided
3/02/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Understanding Voice Problems in Adults Who Survived ICU Stays with a Breathing Machine: A Study from One Hospital
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Scientific title
Assessment of Voice disorder among mechanically ventilated adult ICU survivors – A single-centre observational study (VOICE study)
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Secondary ID [1]
313725
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None
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Universal Trial Number (UTN)
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Trial acronym
VOICE (assessment of VOICE disorder among mechanically ventilated adult ICU survivors)
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Linked study record
A related study protocol by the same PI was registered in CTRI (CTRI/2020/05/025053) in 2020. However, the study could not be initiated due to the COVID-19 pandemic. Therefore it was suspended as updated on CTRI records.
The current study is not a follow-up or sub-study. It is an original study.
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Health condition
Health condition(s) or problem(s) studied:
Voice Disorder
336328
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Condition category
Condition code
Respiratory
332865
332865
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
8
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Target follow-up type
Weeks
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Description of intervention(s) / exposure
Our study focuses on how mechanical ventilation with endotracheal intubation for over 48 hours affects the voice in adult ICU patients. Utilizing the vocal handicap index (VHI-10) and voice-related quality of life (V-RQOL), we measure the impact on voice and overall well-being. The VHI-10, a 10-question questionnaire, assesses the impact of voice problems, with scores above 11 indicating a significant impact. The V-RQOL questionnaire gauges the burden of these issues. Both these Questionnaires will be given to patients at 8 weeks after liberation from mechanical ventilation.
Each questionnaire contains 10 items and it takes approximately 3-4 minutes to complete each questionnaire and 8 minutes in total to complete these self assessment forms.
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Intervention code [1]
330320
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Quantifying voice disorder at 8 weeks after liberation from mechanical ventilation using Rosen’s vocal handicap index (VHI-10) instrument.
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Assessment method [1]
340387
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Vocal handicap index (VHI-10) questionnaire
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Timepoint [1]
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8 weeks following extubation
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Secondary outcome [1]
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To measure the effect of voice disorder on quality of life using voice related quality of life (V-RQOL) instrument.
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Assessment method [1]
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Voice related quality of life (V-RQOL) Questionnaire.
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Timepoint [1]
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8 weeks following extubation.
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Secondary outcome [2]
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Quantifying voice disorder at ICU discharge using Rosen’s VHI-10 instrument among patients who were mechanically ventilated (24-48 hours following extubation or at the time of ICU discharge, whichever comes sooner).
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Assessment method [2]
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vocal handicap index (VHI-10) questionnaire
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Timepoint [2]
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24-48 hours following extubation or at the time of ICU discharge, whichever comes sooner
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Secondary outcome [3]
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Evaluation of risk factors associated with voice disorder.
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Assessment method [3]
443930
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Risk factors of laryngeal injury will be captured by reviewing medical records. following risk factors are captured: • Reason for intubation: Medical (Resp/CNS/CVS)/Surgical/Trauma/Burns: • Emergency or elective intubation: • Peri – intubation CPCR: (yes/no) • Difficult intubation: (yes/no) • CLG grade & POGO • Experience of the operator if available (in years): • Size of ETT • Duration of Ventilation (days) • Re-intubation (yes/no), if Yes: Reason: and Timing of re-intubation • Elective tube exchanges performed: (yes/no), Reason: • Steroid use within 12 hours of extubation (yes/no) • Cumulative fluid balance at extubation • Cuff leak test (Yes/No) • Prior mechanical ventilation in the past 1 year (This includes any General anesthetic procedures performed with invasive ventilation) (yes/no) • Pre-existing voice problems (yes/no)
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Timepoint [3]
443930
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Baseline
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Eligibility
Key inclusion criteria
ICU patients aged 18 years or over, who have been invasively mechanically ventilated for 48 hours or more are planned to transfer from ICU to a ward environment.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Those who have refused to give consent
• Extubated as a part of comfort care/end of life care/discharge against medical advice or to other hospital
• Those who are incapable of interpreting and understanding the questionnaire.
• Those who are unlikely to survive for next 3 months
• Radiotherapy treatment of head and neck region in past 6 months
• Pre-existing laryngeal pathologies
• Those who had a tracheostomy
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
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Timing
Prospective
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Statistical methods / analysis
Summary statistics will be reported using mean and standard deviation for continuous variables and median and IQR for non-normally distributed variables. VHI-10 is an ordinal scale which rates the voice disorder from 0 to 40. Multivariate logistic regression will be used to identify association between the predictors that determine the severity of VHI-10. V-RQOL is also an ordinal scale which rates the quality of life from 10 to 50. Magnitude of V-RQOL change will be reported as median with IQR. Association between VHI and V-RQOL will be tested using Correlation statistics. All the analyses will be carried out using STATA (version:17.0).
Sample size: Following assumptions were made to calculate the sample size.
Since we do not know the incidence of actual voice disorder in the mechanically ventilated ICU survivors, therefore assuming patients who sustain Acute laryngeal injury (ALgI) to have significant voice disorder.
Assuming that 57% of the mechanically ventilated ICU survivors have the ALgI, the study would require a sample size of: 377 patients for estimating the expected proportion with 5% absolute precision and 95% confidence (52% and 62%). Factoring in dropout rate of 20% in the study we require 452 patients, rounded to 455 to test our study hypothesis.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
10/03/2025
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Actual
30/04/2025
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Date of last participant enrolment
Anticipated
9/03/2027
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Actual
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Date of last data collection
Anticipated
4/05/2027
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Actual
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Sample size
Target
455
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Accrual to date
9
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Final
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Recruitment in Australia
Recruitment state(s)
ACT
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Recruitment hospital [1]
27494
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The Canberra Hospital - Garran
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Recruitment postcode(s) [1]
43604
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2605 - Garran
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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The Canberra Hospital Private Practice Fund Administration (TCH PPFA) Funding
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Address [1]
318186
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Kiran Kumar Gudivada, Sr registrar/Fellow, Intensive Care Medicine, The Canberra Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
320572
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Sumeet Rai, Sr Staff Intensivist, Clinical Lead – Research ICU, Intensive Care Medicine, The Canberra Hospital
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Address [1]
320572
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Country [1]
320572
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Australia
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Secondary sponsor category [2]
320579
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Individual
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Name [2]
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Harshel Parikh, Sr Staff Intensivist, Intensive Care Medicine, The Canberra Hospital
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Address [2]
320579
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Country [2]
320579
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Australia
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Secondary sponsor category [3]
320580
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Individual
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Name [3]
320580
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Imogen Mitchell, Executive Director Research and Academic Partnerships, Canberra Health Services and the Australian National University
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Address [3]
320580
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Country [3]
320580
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316838
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ACT Health Human Research Ethics Committee
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Ethics committee address [1]
316838
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https://health.act.gov.au/act-health-system/research-data-and-publications/research/research-ethics-and-governance
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Ethics committee country [1]
316838
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Australia
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Date submitted for ethics approval [1]
316838
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20/06/2024
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Approval date [1]
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25/09/2024
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Ethics approval number [1]
316838
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2024.LRE.00128
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Summary
Brief summary
In hospitals, mechanical ventilation is crucial for critical conditions, commonly initiated in intensive care units through intubation. Unfortunately, about half of patients undergoing this process may suffer acute laryngeal injury, with limited information on its impact on post-ventilator speech. Our study focuses on how ventilator use for over 48 hours affects the voice in adult ICU patients. Utilising the vocal handicap index (VHI-10) and voice-related quality of life (V-RQOL), we measure the impact on voice and overall well-being at 8 weeks following ventilation. The VHI-10, a 10-question questionnaire, assesses the impact of voice problems, with scores above 11 indicating a significant impact. The V-RQOL questionnaire gauges the burden of these issues. Our findings are crucial for identifying predictive factors, enabling early intervention strategies like check-ups, speech therapies, and psychological support for those with voice issues, significantly improving their well-being.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Kiran Kumar Gudivada
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Address
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Department of Intensive Care, Canberra Hospital, Garran 2605, Canberra ACT
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Country
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Australia
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Phone
139162
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+61 02 5124 3303
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Fax
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Email
139162
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[email protected]
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Contact person for public queries
Name
139163
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Nourse, Mary
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Address
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Department of Intensive Care, Canberra Hospital, Garran 2605, Canberra ACT
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Country
139163
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Australia
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Phone
139163
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+61 02 5124 3303
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Fax
139163
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Email
139163
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[email protected]
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Contact person for scientific queries
Name
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Kiran Kumar Gudivada
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Address
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Department of Intensive Care, Canberra Hospital, Garran 2605, Canberra ACT
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Country
139164
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Australia
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Phone
139164
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+61 02 5124 3303
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Fax
139164
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Email
139164
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Type
Citation
Link
Email
Other Details
Attachment
Ethical approval
ACT Health Ethics approval letter
8.4 - 2024.LRE.00128 - Gudivada.pdf
Informed consent form
Kiran Gudivada_VOICE_PIS.doc
Study protocol
VOICE Study protocol - V2-21 sept 2024 clean.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF